摘要
目的:探讨临床治疗盆腔脓肿患者的适宜方式及手术时机。方法:回顾性分析我院妇科2016年1月至2017年1月为86例盆腔脓肿患者施行治疗的资料,根据发热、腹痛症状、急腹症体征、B超或盆腔CT发现盆腔包块,结合实验室指标等诊断盆腔脓肿成立。入院时告知患者盆腔脓肿手术及非手术治疗两种方案,将选择手术治疗的40例患者归为手术组(S1),在入院3 d内行腹腔镜手术;将选择非手术治疗的46例患者归为药物组(M1),采用广谱抗生素静脉输液,并根据药敏结果选择适宜抗生素。1周后对M1组重新评估,再次告知手术及非手术治疗两种方案,将选择手术治疗的18例患者归为手术组(S2),将选择非手术治疗的28例患者归为药物组(M2)。手术组S1+S2共58例采用腹腔镜探查术加病灶切除术,药物组共28例采用广谱抗生素静脉输液治疗共2周。结果:手术组58例盆腔脓肿均顺利完成腹腔镜手术,无一例中转开腹,术后患者发热、腹痛症状消失,盆腔包块基本消失,临床治愈率98.28%,无一例发生膀胱、输尿管、肠道损伤和切口感染等并发症。药物组28例患者发热症状消失,腹痛基本缓解,盆腔包块大部分消失,临床治愈率78.57%。手术与非手术两种治疗方案临床治愈率差异有统计学意义(P<0.05)。手术组中S1组比S2组出血少、费用少,住院时间短(P<0.05)。结论:盆腔脓肿施行腹腔镜手术安全有效,是目前治疗盆腔脓肿较理想的方法,一旦盆腔脓肿诊断确立,建议及早行腹腔镜探查术。
Objective： To explore the appropriate way and the optimal time of operation for the treatment of patients with pelvic abscess. Methods： Clinical data of 86 patients with pelvic abscess in our department of gynecology were retrospectively analyzed from January 2016 to January 2017. According to the symptoms of fever,abdominal pain,signs of acute abdominal pain,and pelvic mass detected by B ultrasound or pelvic CT combined with laboratory indexes,the diagnosis of pelvic abscess were confirmed. On admission,all patients were informed of two regimens： pelvic abscess surgery and non-surgical treatment. 40 patients choosing the surgical treatment were divided into operation group（S1）; they underwent laparoscopic surgery within 3 days of admission. 46 patients choosing non-surgical treatment were divided into drug group（M1）; they were treated with broadspectrum antibiotic intravenous infusion,and antibiotics were selected according to drug susceptibility. After 1 week,the group M1 was reassessed,and then the patients were informed of the two regimens of surgical and non-surgical treatment again. 18 patients choosing the surgical treatment were divided into the operation group（S2）,28 ones choosing non-surgical treatment were divided into the drug group（M2）. All 58 cases in the operation group（S1 ＋ S2） were treated by laparoscopic surgery plus lesion resection,and 28 cases in the drug group were treated with broad-spectrum antibiotics intravenous infusion for two weeks. Results：In the operation group,laparoscopic surgery was performed successfully in 58 cases of pelvic abscess without conversion to laparotomy. After operation,the fever,abdominal pain and symptoms of patients disappeared,the pelvic masses were basically eliminated,the clinical cure rate was 98. 28%,and no complications such as bladder,ureter or intestinal injury and incision infection were found. In 28 cases of the drug group,the fever disappeared,abdominal pain was basically relieved,most of the pelvic mass disappeared,and th
作者
邓玉艳
陆静
王健
DENGYuyan;LUJing;WANGJian(Third People’s Hospital of Chengdu, Chengdu, Sichuan 610031,China)
出处
《现代临床医学》
2018年第3期169-171,174,共4页
Journal of Modern Clinical Medicine
关键词
盆腔脓肿
抗菌药物
腹腔镜手术
手术时机
临床治愈率
pelvic abscess
antibiotics
laparoscopic surgery
optimal operation time
clinical cure rate
